Organization
PRIMESOURCE NURSING SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA PLAUCHE RN (VICE PRESIDENT)
(228) 865-1330
Entity
Organization
Contact information
Practice address
1822 15TH ST STE A, GULFPORT, MS 39501-2104
(228) 865-1330
(228) 865-1331
Mailing address
PO BOX 6705, GULFPORT, MS 39506-6705
(228) 865-1330
(228) 865-1331
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LF0000X
Family Nurse Practitioner
Primary
7381
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06550237
—
MS
Enumeration date
11/10/2006
Last updated
06/08/2026
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